The Central Mediterranean route is the path that many people take in pursuit of a new life. This is often the path to Lampedusa, which entails passing through Libya where migrants are often detained indefinitely. Since 2014, Missing Migrants Project has recorded over 20,000 deaths and disappearances in the Mediterranean Sea. Upon arrival in Italy, migrants often find themselves without the proper support resources to live their lives to the fullest extent. The evidence is overwhelming; of the patients studied at the reception centers in Italy, Médecins sans Frontières (MSF) reported 60.5% of patients showed signs of mental health problems, most commonly post-traumatic stress disorder. Furthermore, the vast majority of them suffer from difficulties related to their current living conditions.

Ambiguous Loss

A recent study conducted by Debora Mazzarelli analyzed the experiences of loss ambiguity in migrants on the Central Mediterranean Route. The researchers tracked a group of migrants in a clinical setting in their reported symptoms, both psychological and somatic. Mazzarelli’s findings report a “complex psychopathological picture resulting from ambiguous loss, migratory and pre-migratory trauma, and integration difficulties in the host country.” The study also considered various resilience factors that may mitigate the levels of suffering, ranging from spiritual connections to a strong commitment to hope in the future.

Closure is a privilege that is often taken for granted. There are some instances in which humanity functions in a rather universal manner, one of these being the process of grief. In order to cope with the loss of a loved one, we endure stages of grief, and we allow for a proper release of the individual in order to allow ourselves to move along in life. Seldom do we experience loss that is not properly acknowledged. Without a definitive declaration of loss, our ability to grieve is stunted and we risk an onset of psychosomatic consequences that ultimately result in life altering trauma.

One approach that has provided an optimistic plan for the future comes from Médecins sans Frontières (MSF). In addition to their search-and-rescue campaigns in the Mediterranean Sea that have saved thousands of lives, MSF has also launched mental health centers across Italy to assist asylum seekers and refugees in need of psychological care. Their 2016 report, “Neglected Trauma” reveals a variety of concerns, including a lack of preventative measures. Risk factors of patients are not being sufficiently addressed until they result in some form of altercation, usually violence. The administrative measures at these facilities are completely flawed and ineffective. They are understaffed and the workers who are there do not have the proper qualifications or training necessary to address the vulnerable populations being treated. One significant area of neglect is the lack of cultural competence and specialization of support that is needed. Mental health and psychosocial support is not a one-size-fits-all approach, and appropriate strategies differ from one population to another. Furthermore, the presence of post-traumatic stress disorder and previous exposure to trauma were highly correlated with psychological instability in patients in their time following arrival. The MSF analysis concludes, “various interventions that included a component of psychological and therapeutic support showed promising results in terms of stress reduction and the strengthening of compensatory strategies and resilience.”